...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Neurosurgery >Gamma knife radiosurgery for pituitary adenoma: early results.
【24h】

Gamma knife radiosurgery for pituitary adenoma: early results.

机译：伽玛刀放射疗法治疗垂体腺瘤：早期结果。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: In recent years, gamma knife radiosurgery (GKRS) has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing GKRS and the complications of this procedure are reviewed. METHODS: Between 1994 and 2002, a total of 78 patients with pituitary adenomas underwent a total of 84 GKRS procedures in our medical center. This patient group comprised 46 men (59%) and 32 women (41%). All patients were treated for recurrent or residual disease after surgery or radiotherapy, with 83% presenting with extensive tumor involvement. The cavernous sinus was involved in 75 patients (96%), and 22 patients (28%) had hormone-secreting adenomas. This latter subset of patients included 12 prolactinomas (15%), 6 growth-hormone secreting tumors (8%), and 4 adrenocorticotropic hormone-secreting tumors (5%). The median tumor volume was 2.3 cm(3), and the median radiation dose was 15 Gy defined to the 50% isodose line. The mean and median follow-up periods were 41 and 36 months, respectively. RESULTS: GKRS was tolerated well in these patients; acute toxicity was uncommon and of no clinical significance. Late toxicity was noted in three patients (4%) and consisted of VIth cranial nerve palsy. In two patients, there was spontaneous resolution of this palsy, and in one patient, it persisted for the entire 3-year duration of follow-up. Of the 15 patients who presented with cranial nerve dysfunction, 8 (53%) experienced complete recovery and 3 (20%) showed major improvement within 12 months of therapy. Tumor volume reduction was slow, with 30% of patients showing decreased tumor volume more than 3 years after undergoing GKRS. None of the 56 patients with nonfunctioning tumors showed progression in the treated volume, and 4 (18%) of the 22 hormone-secreting tumors relapsed (P = 0.008). Of the four patients with adrenocorticotropic hormone-secreting adenomas, therapy failed in two of them. All six patients with growth hormone-producing tumors responded well to therapy. Of the 12 patients with prolactinomas 10 (83%) had normalization of hormone level and 2 patients experienced increasing prolactin level. Two patients with prolactinomas had three normal pregnancies after undergoing GKRS. CONCLUSION: GKRS is a safe and effective therapy in selected patients with pituitary adenomas. None of the patients in our study experienced injury to the optic apparatus. A radiation dose higher than 15 Gy is probably needed to improve control of hormone-secreting adenomas. Longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.
机译：目的：近年来，伽马刀放射外科（GKRS）已成为垂体腺瘤治疗的重要治疗手段。回顾了进行GKRS后的治疗结果以及该过程的并发症。方法：从1994年到2002年，我们的医疗中心共对78例垂体腺瘤患者进行了84次GKRS手术。该患者组包括46名男性（59％）和32名女性（41％）。所有患者均在手术或放疗后接受了复发或残留疾病的治疗，其中83％表现为广泛的肿瘤受累。海绵窦涉及75例（96％），22例（28％）患有分泌激素的腺瘤。后一组患者包括12个泌乳素瘤（15％），6个生长激素分泌肿瘤（8％）和4个促肾上腺皮质激素分泌肿瘤（5％）。中位肿瘤体积为2.3 cm（3），中位辐射剂量为15 Gy（定义为50％等剂量线）。平均和中位随访期分别为41个月和36个月。结果：这些患者对GKRS的耐受性良好。急性毒性罕见，无临床意义。注意到三名患者（4％）出现晚期毒性，包括第六次颅神经麻痹。在两名患者中，该麻痹有自发性消退，在一名患者中，其持续了整整三年的随访。在表现为颅神经功能障碍的15例患者中，有8例（53％）完全康复，而3例（20％）在治疗12个月内显示出重大改善。肿瘤体积减小缓慢，接受GKRS后超过3年的患者中有30％的患者肿瘤体积减小。 56名无功能性肿瘤的患者中没有一个在治疗体积上显示进展，并且22种分泌激素的肿瘤中有4名（18％）复发（P = 0.008）。在患有促肾上腺皮质激素分泌腺瘤的四名患者中，其中两名患者治疗失败。所有六名产生生长激素的肿瘤患者对治疗反应良好。在12名泌乳素瘤患者中，有10名（83％）的激素水平恢复正常，而2名患者的催乳素水平升高。两名泌乳素瘤患者接受GKRS治疗后，三胎正常。结论：GKRS是一种针对某些垂体腺瘤患者的安全有效的治疗方法。在我们的研究中，没有患者遭受光学装置的伤害。可能需要高于15 Gy的辐射剂量以改善对激素分泌腺瘤的控制。需要更长时间的随访，以更全面地评估晚期毒性和治疗效果。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号